{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:11:08Z","timestamp":1779167468207,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Papilledema is thought to be the hallmark sign of increased intracranial pressure (ICP). Distension of the subarachnoid space within the optic nerve sheath is also commonly reported in MR studies as an indirect sign of increased ICP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>General anesthesia and positive pressure ventilation might result in changes in optic sheath diameter (OSD) observed on clinical brain MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>One hundred forty\u2010five \u00a0patients (154 MRI scans, 7.3\u2009years\u2009\u00b1\u20095.1); 97 studies in the anesthesia group (4.4\u2009years\u2009\u00b1\u20093.4) of which 22 had papilledema, and 57 in the non\u2010anesthesia group (12.3\u2009years\u2009\u00b1\u20093.2), of which 28 had papilledema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5T or 3.0T volumetric T2 images. T2 images were obtained from different vendors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>OSD, optic nerve diameter (OND), and peri\u2010optic cerebrospinal fluid (CSF) were measured manually on T2\u2010weighted MR images for various population subgroups (with and without anesthesia; with or without papilledema). The correlation between these measurements and the clinical diagnosis of papilledema was evaluated via receiver operating characteristic (ROC) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Chi\u2010square test; Mann\u2013Whitney Test; Spearman's test and ROCs; Interclass correlation coefficient, <jats:italic>P<\/jats:italic>\u2009=\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>General anesthesia resulted in significantly larger mean OSD in patients with or without papilledema (7.3\u2009\u00b1\u20091.0\u2009mm vs. 6.1\u2009\u00b1\u20091.1\u2009mm and 6.7\u2009\u00b1\u20091.0\u2009mm vs. 5.4\u2009\u00b1\u20090.9\u2009mm, respectively). In the non\u2010anesthesia group, the average OSD values (6.1\u2009\u00b1\u20091.1\u2009mm) were significantly higher in papilledema patients compared to non\u2010papilledema patients (5.4\u2009\u00b1\u20090.9\u2009mm), with larger peri\u2010optic CSF rim (1.6\u2009\u00b1\u20090.4\u2009mm vs. 1.3\u2009\u00b1\u20090.3\u2009mm). In the anesthesia group, OND was significantly larger in papilledema patients (3.4\u2009\u00b1\u20090.4\u2009mm vs. 3.1\u2009\u00b1\u20090.5\u2009mm), though the average peri\u2010optic CSF rim did not reach a significance in papilledema compared with non\u2010papilledema patients (2.0\u2009\u00b1\u20090.3\u2009mm vs. 1.8\u2009\u00b1\u20090.4\u2009mm, <jats:italic>P<\/jats:italic>\u2009=\u20090.06). In patients with general anesthesia, peri\u2010optic CSF rim had a limited correlation with increased ICP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>In the pediatric population, imaging findings of increased OSD on brain MRI might be related to general anesthesia rather than increased ICP. The interpretation of optic nerve sheath distention should be reported cautiously in conjunction with anesthesia status, especially in the pediatric population.<\/jats:p><jats:p>Evidence Level: 4<\/jats:p><jats:p>Technical Efficacy: 5<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28734","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T15:27:23Z","timestamp":1681399643000},"page":"1875-1881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of General Anesthesia on <scp>MR<\/scp> Optic Nerve Sheath Diameter in the Pediatric Population"],"prefix":"10.1002","volume":"58","author":[{"given":"Israel","family":"Cohen","sequence":"first","affiliation":[{"name":"Section of Neuroradiology, Division of Diagnostic Imaging Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matan","family":"Kraus","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Division of Diagnostic Imaging Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gahl","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Division of Diagnostic Imaging Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Division of Diagnostic Imaging Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8954-3244","authenticated-orcid":false,"given":"Shai","family":"Shrot","sequence":"additional","affiliation":[{"name":"Section of Neuroradiology, Division of Diagnostic Imaging Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv 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